Individual provider Active NPI

Michael V. Ouimette, M.D.

  • Diagnostic Radiology Physician
  • Marquette, MI
National Provider Identifier
1114960903
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301039723 Issued in MI
Practice address
580 W College Ave
Marquette, MI 49855-2705
Phone
(906) 225-7808
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301039723 MI Primary

Addresses

Primary practice location

580 W College Ave
Marquette, MI 49855-2705

Mailing address

2837 US 41 W
Marquette, MI 49855-2252
Phone (906) 225-3964

Other identifiers 4

IdentifierTypeStateIssuer
1600069OtherMIPHP
310E210240OtherMIBLUE CROSS BLUE SHIELD OF MICHIGAN
2672870MedicaidMI
3003304611OtherMIBCBS MI INDIVIDUAL PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031222000846 MI Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 3779481445 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Imaging Specialists, PC CurrentSince Apr 28, 2008 Accepting new patients
Lansing Radiology Associates P C Diagnostic Radiology Past Accepting new patients
Marquette General Hospital, Inc. Past Accepting new patients
Memorial Hospital Past Accepting new patients

Locations

580 W College Ave
Fl 4
Marquette, MI 49855
Phone (906) 225-7808

717 W Washington St
Ste C
Marquette, MI 49855
Phone (906) 225-7808

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

2833 US Highway 41 W
Marquette, MI 49855

2837 US Highway 41 W
Marquette, MI 49855
Phone (906) 225-3964

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1114960903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2837 US 41 W",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552252",
            "telephone_number": "906-225-3964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W COLLEGE AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552705",
            "telephone_number": "906-225-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUIMETTE",
        "first_name": "MICHAEL",
        "middle_name": "V.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301039723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "1600069",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "310E210240",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2672870",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI INDIVIDUAL PIN",
            "identifier": "3003304611",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.